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+--- Thread: Seperate charge for integrated humidifier (/Thread-Seperate-charge-for-integrated-humidifier)
Seperate charge for integrated humidifier - SpeedyD - 02-23-2016
How can the DMA possibly charge me seperate for a humidifier that is part of the machine?? This was not on my January bill and on February it is on there twice! I think I need to report them to someone. Do I call insurance fraud or what?
RE: Seperate charge for integrated humidifier - Sleeprider - 02-23-2016
This is typical billing practice and is generally allowed and almost required by the method for billing DME which requires all the components to be coded for reimbursement from insurance. It maximizes the billed amount, and does not change the ultimately allowed amount. If you are paying out of pocket, however you'll be screwed.
DMEs individually code the machine, humidifier, hose, filters, mask cushion, head gear and mask frame. They can bill fantasy prices, but get reimbursed by insurance, according to a contractual allowed amount. I have heard of people complaining to their state's attorney general or consumer affairs offices and having the charges reversed. Especially if it is being paid out of pocket. The Resmed integrated humidifier really threw a wrench into the works. Respironics continues to have modules that can be separated.
RE: Seperate charge for integrated humidifier - justMongo - 02-23-2016
Asked and answered.
If you are paying out of pocket, you might get relief by calling the dispensing company.
Depending on which criminals DME you are dealing with.
US Medicare has been allowing this practice; and most insurance companies follow Medicare rules.
It would be difficult to fight in court.
Most states do have a State Health Insurance Program (SHIP) that may advocate for you.
There is also a state insurance commissioner. If the commissioner is nearing election time; they might also get involved.